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Strehlow G.,Clinic for Psychiatry and Psychotherapy | Lindner R.,Geriatric Psychosomatics and Psychotherapy
Nordic Journal of Music Therapy

Music therapy for patients suffering from borderline personality disorder (BPD) has been a standard treatment option for many years in in-patient psychiatric work. The BPD symptoms, such as identity disturbance, emotional regulation and unstable relationships, lead to challenging and stormy therapy sessions for all therapists of all disciplines. In music therapy, difficulties in treatment include, for example, the patient’s refusal to play, extreme loud music or withdrawal from the process. This article presents the method and results of a systematic qualitative research of 20 BPD female patients undergoing individual psychoanalytical music therapy in an acute psychiatric context. The aim of the research was to identify typical interaction patterns, arising from the relationship between patient and therapist and also from the significance of music. The method “forming types by understanding” is based on the well-known sociological research method of “ideal types”. Abstracted results are generated by contrasting cases, and the research process is validated through communicative validation. In total, it was possible to identify 10 typical interaction patterns within music therapy, reflecting typical BPD themes such as regulation of proximity and distance, splitting phenomena, trauma genesis, aggression and mentalization. The 10 typical interaction patterns of BPD patients have provided a way of accessing individual music therapy cases and making them much easier to understand. The interaction patterns help to maintain and reconstruct the therapist’s capacity to play, improvise and to mentalize. © 2015 The Grieg Academy Music Therapy Research Centre. Source

Goldblatt M.J.,Harvard University | Briggs S.,University of East London | Lindner R.,Geriatric Psychosomatics and Psychotherapy | Schechter M.,Harvard University | Ronningstam E.,Harvard University
Psychoanalytic Psychotherapy

Although the treatment of suicidal adolescents is complex and may be daunting to many clinicians, it continues to play an important role in suicide prevention. In this paper, we use case material to address questions that arise in psychotherapy, including the contending priorities of understanding the suicidal act in order to prevent repetition, versus connecting emotionally with the patient in the therapeutic relationship; and the use of an evolving understanding of the complexity of suicide that develops over time as patient and therapist engage in a deepening relationship which fosters life-sustaining development and psychic change. We present a case description of a patient in later adolescence, who began intensive psychoanalytic psychotherapy after a suicide attempt and explore key components of therapeutic action. From this discussion we emphasise the relational aspects of the transference and countertransference that enables interpretation and increased therapeutic receptivity through collaborative interaction. We conclude that collaborative interaction is foundational for therapeutic action with suicidal adolescents. © 2015, © 2015 The Association for Psychoanalytic Psychotherapy in the NHS. Source

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